Dr.Chekitaan Singh, Dr.Reena Gupta, Dr.Ishwar Singh, Dr.Ashok Kumar Khurana
We describe management of a challenging case of IOL(4- haptic foldable lens) drop in a 7 month infant with capsular phimosis. We made 3 ports 2mm from the limbus, used 20G system allowing greater and forceful manipulation. PVD induction failed inspite of multiple attempts. The vitreous was carefully shaved away from the IOL surface, failing to free it, it was gently rotated on the retinal surface and additional vitreous cut. The IOL was lifted with a forceps, two haptics were sequentially brought in the AC with light pipe and forceps with great difficulty. The IOL was now badly stuck within the small capsular opening(3mm). No relaxing incisions in the capsular opening were given as it would compromise IOL support after repositioning, risking another drop. We now made a clear corneal incision inferiorly and pulled the IOL in AC with a max grip forceps. The IOL was repositioned in the sulcus with a dialer. The surgery was uneventful with a quiet eye and well centred IOL post operatively.